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Kids/Youth Camp Registration

 
2015 Kids/Youth Cricket Camp/League
Registration and Consent Form
 
Child1 FirstName:
Last Name:
Child2 FirstName:
Last Name:
Child1 Age
Child2 Age:
Mother Name:
Father Name:
Contact Phone#1:
Phone#2:
Email address:
Emergency ContactName:
Contact Number:
Human Check Add(7+8+2015):
 
 
 
Camp/League Fee is $20 - Check payable to PAUCA
Mailing Address:
Attn: PAUCA Treasurer
Kumar Emany
14 Turmeric Dr,
Mechanicsburg, PA - 17050
 
CONSENT & LIABILITY WAIVER:

I  hereby consent to my child’s participation in kids cricket coaching and league with Pennsylvania United Cricket Club (PAUCA). I also agree to forever release the PAUCA a non-profit organization, and their board members, coaches, volunteers and any and all individuals and organizations assisting or participating in voluntary kids cricket coaching  and league programs by PAUCA (“the Releasees”) from any and all claims, rights of action and causes of action,  damages, costs, loss of services,  expenses, compensation and attorney’s fees that may have arisen in the past, or may arise in the future, directly or indirectly, from personal injuries to my child or property damage resulting from my child’s participation in the PAUCA kids cricket coaching  and league programs.

I hereby affirm that my child is in good physical condition to play cricket. His participation is purely voluntary and in no way mandated by Pennsylvania United Cricket Association (PAUCA). Also, I understand that he can stop anytime if he has any discomfort or even without any particular reason.

I also promise, to indemnify, reimburse, defend, and hold harmless "the Releasees" against any and all legal claims and proceedings of any description that may have been asserted in the past, or may be asserted in the future, directly or indirectly, arising from personal injuries to my child or property damage resulting from my child’s participation in the PAUCA kids cricket coaching  and league programs or administration of first aid.  PAUCA bears no responsibility whatsoever for any loss which he may suffer during the activities if caused by either his own negligence, inadequacies in health and fitness or by accident.

I further affirm that I have read this Consent and Release Agreement and that I understand the contents of this Agreement. 
 
 

The Pennsylvania United Cricket Association is a project of The Foundation for Enhancing Communities, fiscal sponsor.

Copyright(c) 2013 Pennsylvania United Cricket Association (PAUCA). All rights reserved.

The official registration and financial information of The Foundation for Enhancing Communities may be obtained from the Pennsylvania Department of State by calling toll free, within Pennsylvania, 1.800.732.0999. Registration does not imply endorsement.